- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... environment.* Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal communication skills.*… more
- New York State Civil Service (Montrose, NY)
- …Mental Health Nurse , (including all parenthetic), Infection Control Nurse , or Senior Utilization Review Nurse ;Or 2. One year in any Grade 16 or ... NY HELP Yes Agency Health, Department of Title Registered Nurse Supervisor 1 (NY HELPS) (Veterans Home at Montrose)...State NY Zip Code 10548 Duties Description The Registered Nurse Supervisor 1 will be responsible for the direction… more
- Trinity Health (Albany, NY)
- …requirements for Utilization Management and works collaboratively with Utilization Management/Concurrent Review Nurse , physicians, staff and ... identification of possible concurrent denials, forwards information to the appropriate Utilization Management/Concurrent Review Nurse within identified… more
- New York State Civil Service (Albany, NY)
- …of post-licensure clinical nursing experience of which one year was in utilization review and/or discharge planning.Substitution: a bachelor's degree in nursing ... HELP No Agency Corrections and Community Supervision, Department of Title Registered Nurse 3 - Utilization Temp/Hourly Occupational Category Health Care,… more
- CVS Health (Albany, NY)
- …Monday through Friday 8:30-5pm EST. No weekends or holidays. + 1+ years of utilization review / utilization management required. + 3+ years of behavioral ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in… more
- Ellis Medicine (Schenectady, NY)
- Basic Function: The Utilization Management Registered Nurse (UM RN) supports daily coordination of care across healthcare continuum with the healthcare team, ... responsible for preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures the appropriate level of… more
- Healthfirst (NY)
- **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review , ... reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems + Allocate, monitor,… more
- WMCHealth (Valhalla, NY)
- …implementation or investigation of the procedures specified in the Quality Management, Utilization Review and Discharge Planning Program at Westchester Medical ... York State Department of Education, as a registered professional nurse . Training and Experience: three years of experience where...of which must have been in the area of utilization review , quality assurance, risk management or… more
- Mount Sinai Health System (New York, NY)
- …influence other services by focusing on patient processes. 9. Develops and implements Utilization Review (UR) based on internal data collection, data received ... the delivery of comprehensive front-line Case Management services, including utilization management, care facilitation and discharge planning. The Assistant Director… more
- Elevance Health (Latham, NY)
- …prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification ... ** Utilization Management Representative I** **Virtual:** This role enables...responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing… more
- Centene Corporation (New York, NY)
- …criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care + ... + Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high quality and cost-effective medical care to… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title: Nurse Practitioner-Adolescent Health - Mount Sinai Hospital - Full Time - Day** A nurse practitioner (NP) as described in Title ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion… more
- Mount Sinai Health System (New York, NY)
- **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion… more
- Bassett Healthcare (Cooperstown, NY)
- …discuss specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Special Care unit is accountable for the ... needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for a new nurse… more
- Albany Medical Center (Albany, NY)
- …Demonstrates experience in the referral process and use of community resources. 2. Utilization Review a. Reviews data from admission screening to clarify ... changing environment. 8. Basic knowledge of computer systems with skills applicable to utilization review process. Mission, Core Values and Service Excellence 1.… more
- Veterans Affairs, Veterans Health Administration (Castle Point, NY)
- …orientation, competencies, and providing quality improvement and outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic ... (MDS) coordinator to ensure documentation is accurate and reflective of the Resource Utilization Group (RUG) score. This position is eligible for the Education Debt… more
- Arnot Health (Bath, NY)
- …for professional/practice development. + Completes employee evaluations within the month of review date. Standard III. Education The Nurse Manager acquires and ... suitable for nursing research. + Promotes research-based practice. Standard VIII. Resource Utilization The Nurse Manager evaluates and administers the resources… more
- Rochester Regional Health (Rochester, NY)
- …soon as possible after admission-within the first 12 to 24 hours. Applies utilization review criteria to assess and document appropriateness of admission, ... Job Title: Nurse NavigatorDepartment: Oncology Location: Canton-Potsdam Hospital Hours Per Week: 37.5 scheduled weekly hoursSchedule: 7.5-hour day shift SUMMARY:… more
- Mount Sinai Health System (New York, NY)
- **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion… more